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Search › New Jersey › 207Q00000X

Kenneth Distefano, MD

NPI 1619146677 · on the registry since 2008 · sole proprietor

Practice

Address
1 Mount Prospect Ave
Verona, NJ 07044
Phone
(973) 239-7777
Fax
(973) 239-7082
Organisation at this address
Champey Pain Group
Robert J Agresti Do Pa
Mine Hill Anesthesia Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
5

Registry record

Primary taxonomy
207Q00000X
207Q00000X
Also registered as
207Q00000X
Licence states on file
NJ, NY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2011-01-05

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Jersey